S Lahme1, T Götz, K-H Bichler. 1. Department of Urology, University of Tuebingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. sven.lahme@med.uni-tuebingen.de
Abstract
OBJECTIVES: Surgical correction of penile deviation in patients with Peyronie's disease by tunical plication often leads to shortening of the penis. It is, thus, recommendable to combine tunical plication with plaque incision or excision. The resulting tunical defect, however, requires grafting, and various techniques have been described. In comparison with tunical plication, all of these combined techniques are associated with increased operation time, mainly due to additional procedures necessary at the donor site, and may result in defects at the donor site. We here report a novel surgical technique by which tunical defects after partial excision of plaques are covered by a ready-to-use collagen fleece coated with tissue sealant (TachoComb). METHOD: A prospective clinical observation trial was conducted in 19 patients with penile deviation due to Peyronie's disease. RESULTS: In all patients, a reliable closure of the Tunica albuginea was achieved, and no postoperative haematoma formation was observed. Postoperatively, none of the patients suffered from erectile dysfunction. During the follow-up period of 25 months, objective and subjective improvement was 83% and 72%, respectively. CONCLUSION: The present data indicate that this novel surgical technique may be of benefit in patients with Peyronie's disease and should thus be further evaluated.
OBJECTIVES: Surgical correction of penile deviation in patients with Peyronie's disease by tunical plication often leads to shortening of the penis. It is, thus, recommendable to combine tunical plication with plaque incision or excision. The resulting tunical defect, however, requires grafting, and various techniques have been described. In comparison with tunical plication, all of these combined techniques are associated with increased operation time, mainly due to additional procedures necessary at the donor site, and may result in defects at the donor site. We here report a novel surgical technique by which tunical defects after partial excision of plaques are covered by a ready-to-use collagen fleece coated with tissue sealant (TachoComb). METHOD: A prospective clinical observation trial was conducted in 19 patients with penile deviation due to Peyronie's disease. RESULTS: In all patients, a reliable closure of the Tunica albuginea was achieved, and no postoperative haematoma formation was observed. Postoperatively, none of the patients suffered from erectile dysfunction. During the follow-up period of 25 months, objective and subjective improvement was 83% and 72%, respectively. CONCLUSION: The present data indicate that this novel surgical technique may be of benefit in patients with Peyronie's disease and should thus be further evaluated.